| NPI | 1083257778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRESSA OSTA Owner/Counselor 339-298-8055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |